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Spinal Cord Stimulation for Intractable Visceral Pain Originating from the Pelvic and Abdominal Region: A Narrative Review on a Possible New Indication for Patients with Therapy-Resistant Pain.

作者信息

Bieze Matthanja, van Haaps Annelotte Pauline, Kapural Leonardo, Li Sean, Ferguson Kris, de Vries Ralph, Schatman Michael E, Mijatovic Velja, Kallewaard Jan Willem

机构信息

Department of Anesthesiology and Pain Management, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands.

Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.

出版信息

J Pain Res. 2024 Feb 19;17:691-736. doi: 10.2147/JPR.S445616. eCollection 2024.


DOI:10.2147/JPR.S445616
PMID:38405684
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10887953/
Abstract

AIM: Visceral pain, characterized by pain that is diffuse and challenging to localize, occurs frequently and is difficult to treat. In cases where the pain becomes intractable despite optimal medical management, it can affect patients' Quality of Life (QoL). Spinal Cord Stimulation (SCS) has emerged as a potential solution for intractable visceral pain. PURPOSE: In this narrative review, we collected all evidence regarding the efficacy of SCS for visceral pain across various underlying conditions. METHODS: A comprehensive literature search was conducted in PubMed, Embase, and Web of Science in which articles published from October 1st, 1963 up to March 7th, 2023 were identified. RESULTS: Seventy articles were included in this review of which most were retrospective cohort studies, case series and case reports. The studies, often with a small number of participants, reported on SCS for chronic pancreatitis, anorectal pain and bowel disorders, gynaecological diagnoses, visceral pelvic pain, urological disorders and finally general visceral pain. They found positive effects on pain and/or symptom relief, opioid consumption, anxiety and depression and QoL. Complications occurred frequently but were often minor and reversible. CONCLUSION: Better screening and selection criteria need to be established to optimally evaluate eligible patients who might benefit from SCS. A positive outcome of a sympathetic nerve block appears to be a potential indicator of SCS effectiveness. Additionally, women receiving SCS for endometriosis had a better outcome compared to other indications. Finally, SCS could also relief functional symptoms such as voiding problems and gastroparesis. Complications could often be resolved with revision surgery. Since SCS is expensive and not always covered by standard health insurance, the incorporation of cost-analyses is recommended. In order to establish a comprehensive treatment plan, including selection criteria for SCS, rigorous prospective, possibly randomized and controlled studies that are diagnosis-oriented, with substantial follow-up and adequate sample sizes, are needed.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16c3/10887953/68f9da4c28cd/JPR-17-691-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16c3/10887953/68f9da4c28cd/JPR-17-691-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16c3/10887953/68f9da4c28cd/JPR-17-691-g0001.jpg

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引用本文的文献

[1]
Spinal Cord Stimulation for Diffuse Visceral Hyperalgesia in the Abdomen: A Case Report and Literature Review.

Case Rep Gastroenterol. 2025-6-18

[2]
16. Pain in chronic pancreatitis.

Pain Pract. 2025-4

[3]
Good long-term results of sacral neuromodulation for endometriosis related chronic pelvic pain.

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[4]
An Algorithmic Overview of Advanced Pain Therapies: A Narrative Review.

Curr Pain Headache Rep. 2025-1-27

[5]
Neuromodulation in chronic pain management: addressing persistent doubts in spinal cord stimulation.

J Anesth Analg Crit Care. 2025-1-6

本文引用的文献

[1]
Neuromodulation for Management of Chronic Pelvic Pain: A Comprehensive Review.

Pain Ther. 2022-12

[2]
Treatment of nonsurgical refractory back pain with high-frequency spinal cord stimulation at 10 kHz: 12-month results of a pragmatic, multicenter, randomized controlled trial.

J Neurosurg Spine. 2022-2-11

[3]
Spinal cord stimulation in the approach to chronic pelvic pain: A case report and literature review.

Medicine (Baltimore). 2021-12-30

[4]
Long-term results of sacral neuromodulation for the treatment of anorectal diseases.

J Visc Surg. 2022-12

[5]
Pulse Dosing of 10-kHz Paresthesia-Independent Spinal Cord Stimulation Provides the Same Efficacy with Substantial Reduction of Device Recharge Time.

Pain Med. 2022-1-3

[6]
Optimal management of functional anorectal pain: a systematic review and network meta-analysis.

Eur J Gastroenterol Hepatol. 2022-3-1

[7]
Effects of Spinal Cord Stimulation in Patients with Chronic Nausea, Vomiting, and Refractory Abdominal Pain.

Dig Dis Sci. 2022-2

[8]
Neuromodulation in Treating Pelvic Pain.

Curr Pain Headache Rep. 2021-2-3

[9]
Long-term Outcomes of Sacral Nerve Stimulation in Pelvic Floor Dysfunctions.

Int Neurourol J. 2021-12

[10]
Neuromodulation for Chronic Pelvic Pain: A Single-Institution Experience With a Collaborative Team.

Neurosurgery. 2021-3-15

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